Disorders of the central nervous system in pregnancy

J. Martinez-Tica, Rakesh Vadhera

Research output: Chapter in Book/Report/Conference proceedingChapter

3 Citations (Scopus)

Abstract

Introduction Disorders of the central nervous system (CNS) during pregnancy remain a common cause of maternal morbidity and mortality. Central nervous system disease was responsible for 34 of the 90 indirect causes of death during the 1997–1999 Confidential Enquiry into Maternal Deaths in England and Wales. Intracranial hemorrhage was responsible for 21 of these deaths. Some disease processes pre-date pregnancy, such as epilepsy, Parkinson disease, multiple sclerosis, intracranial lesions, benign intracranial hypertension, or migraine. Other conditions have an increased incidence during pregnancy, for example cerebrovascular disorders, including hemorrhagic or vaso-occlusive strokes. Few centers have extensive experience treating these CNS disorders, so management is based on isolated case reports, basic principles, and common sense. Maternal vegetative states and brain death situations present medico-legal and ethical dilemmas. Issues important to the care of the parturient with a CNS disorder include: the pathophysiology of the lesion the impact of pregnancy on the lesion impact of medical management, monitoring, and surgery on the fetus the potential for aortocaval compression from lead shielding during diagnostic radiological procedures gastric aspiration during pregnancy in mentally obtunded patients maternal versus fetal priority with respect to surgical plan, timing, and route of delivery communication and coordination among the patient, her family, and the medical team (neurologist, neurosurgeon, obstetrician, anesthesiologist, medical consultants, and nursing staff). Diagnostic tests A number of intracranial conditions can produce similar signs and symptoms in the parturient (see Table 9.1). A high index of suspicion for unusual conditions is important because aggressive treatment greatly affects outcome.

Original languageEnglish (US)
Title of host publicationObstetric Anesthesia and Uncommon Disorders, 2nd Edition
PublisherCambridge University Press
Pages167-190
Number of pages24
Volume9780521870825
ISBN (Print)9780511544552, 9780521870825
DOIs
StatePublished - Jan 1 2008

Fingerprint

Central Nervous System Diseases
Pregnancy
Mothers
Parturition
Persistent Vegetative State
Pseudotumor Cerebri
Cerebrovascular Disorders
Maternal Death
Brain Death
Intracranial Hemorrhages
Maternal Mortality
Nursing Staff
Medical Staff
Wales
Consultants
Migraine Disorders
Routine Diagnostic Tests
England
Multiple Sclerosis
Signs and Symptoms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Martinez-Tica, J., & Vadhera, R. (2008). Disorders of the central nervous system in pregnancy. In Obstetric Anesthesia and Uncommon Disorders, 2nd Edition (Vol. 9780521870825, pp. 167-190). Cambridge University Press. https://doi.org/10.1017/CBO9780511544552.010

Disorders of the central nervous system in pregnancy. / Martinez-Tica, J.; Vadhera, Rakesh.

Obstetric Anesthesia and Uncommon Disorders, 2nd Edition. Vol. 9780521870825 Cambridge University Press, 2008. p. 167-190.

Research output: Chapter in Book/Report/Conference proceedingChapter

Martinez-Tica, J & Vadhera, R 2008, Disorders of the central nervous system in pregnancy. in Obstetric Anesthesia and Uncommon Disorders, 2nd Edition. vol. 9780521870825, Cambridge University Press, pp. 167-190. https://doi.org/10.1017/CBO9780511544552.010
Martinez-Tica J, Vadhera R. Disorders of the central nervous system in pregnancy. In Obstetric Anesthesia and Uncommon Disorders, 2nd Edition. Vol. 9780521870825. Cambridge University Press. 2008. p. 167-190 https://doi.org/10.1017/CBO9780511544552.010
Martinez-Tica, J. ; Vadhera, Rakesh. / Disorders of the central nervous system in pregnancy. Obstetric Anesthesia and Uncommon Disorders, 2nd Edition. Vol. 9780521870825 Cambridge University Press, 2008. pp. 167-190
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